Squamous cell carcinoma (SCC) of the tongue has an increasing incidence, a high morbidity rate and a 50% 5-year mortality rate. We analyzed the rate of apoptosis using TDT-mediated dUTP-biotin nick end-labeling (TUNEL), p53 and heparanase in 73 patients with tongue cancer by immonohistochemistry, and tested data for correlation with survival, tumor size, grade and metastasis. TUNEL staining was strong in 54% of the tumors; the remainder lacked staining, as did all healthy control tissues. Significant correlations were found between TUNEL staining level and p53 expression rates (p=0.016) and between TUNEL and heparanase (p=0.039). Moreover, while the cumulative 5-year survival probability for tumors not stained for TUNEL and p53 was 63%, but dropped to 34% with TUNEL staining; for lack of TUNEL and heparanase (=0), 5-year survival rate was 50%, while staining presence (>0) reduced survival to 34%. TUNEL joins other biomarkers in indicating prognosis of understanding pathogenesis of tongue cancer.